Lori Lynne Armstrong, Writer

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More than usual, I mean; my general diagnosis includes a type of depression. But just because I told him about how often I’ve been thinking about death lately, and how much I’ve been struggling with food and other self-destructive behavior, and how much time I spend in circles that talk a great deal about the dark aspects of all our futures on this planet…he thinks I need more help with depression.

So out he comes with this particular health care organization’s chart of meds and starts suggesting things to add to my regimen.

Poor man. He means well. But either he hasn’t been taking notes at our previous sessions, or he hasn’t been looking at them.

The names of the meds are listed in little boxes by group, and as he proposes things I have to keep shooting him down.

No, we can’t add anything from this box. I’ve tried many of them, and they increase anxiety to a dangerous level. No, I don’t care if this one is new, I’ve seen the chemical formula. They moved a hydrogen atom so they could get a new patent, that’s all.

No, we can’t add anything from this box. They’re all addictive. I know my addiction history is in my chart. I made a point of putting it there.

Dear God, no, we can’t add anything from this box. Two of them almost killed me when I tried them; I’ve told you that before. You cannot give me any of these unless I’m an inpatient under close supervision so I don’t walk into traffic.

We could try a slight increase in this one med I’m already taking, or we could try one from this tiny box here…or maybe we could get me a therapist I could see more than once every six weeks.

This week I am receiving a reminder of this. I did something to my back 8 days ago; thought it was no big deal at first but it got worse as the week went on. It’s been hurting at the level that used to be going on all the time for me.

I’m spoiled these days; often pain free with occasional flareups. I haven’t had one this bad in four years or more.

So right now I’m being reminded how much pain screws me up–and I’m getting to see how it screws up parts of myself necessary for writing.

One: Pain makes me afraid. I future trip like crazy–what if it doesn’t get better? When can I go back to my regular activities? How am I going to function when sometimes I can barely function without pain? Writing in a state of fear tends to be joyless and stripped of its usual juice.

Two: Pain makes me stupid. Even less sleep than usual, fatigue from stiff muscles; it all leaves me cloudy. Writing is slow and awkward.

Three: Pain triggers bad memories and cravings. Back pain will always be associated with the worst time of my addiction. The physical sensation triggers memories of standing in line, filling out forms, and talking to doctors in order to get more painkillers. Even though I know all that is in the past, my body isn’t sure. Writing is harder because it’s difficult to stay in the present.

Four: Pain ups my level of depression. Understandable. Limited mobility leads to boredom, which makes me more vulnerable to depressive content from my head. Writing is harder because the grayness of depression works against my creativity.

Five, and most dangerous of all: Pain makes me self-absorbed. I regress, as many in chronic pain do, to an ego state where I lose perspective and my pain becomes the center of the universe. Writing is hard because I lose touch with why I write.

I really hope this won’t last much longer. But if it does, I need to remember that the imperfect writing I can do in this state is still approximately ten thousand times better than a blank page. So what if it’s not quite up to my usual standards? That’s what editing is for.

How do I maximize my usefulness to others? How do I assess my strengths and weaknesses honestly and make good choices about how hard I should push myself at any given time? How do I repeat this assessment frequently and deal with the self-doubt that tries to make me push myself too hard out of guilt or shame? How do I resist the impulse to apologize constantly for what I am doing and the fact that it’s not enough?

I’ve written on this theme before. I’m sure I will write about it at intervals for the rest of my life. Two years ago I wrote this, in fact:

“I don’t want to live my life as a walking apology, but I also don’t want to become the kind of person who sees no need for regrets about how my condition and/or my shortcomings affect others.

Where is the line; where does a realistic assessment of my condition end and making excuses begin?

Could I be allowed to stop making promises, or even implied promises, that set me up for the inevitable apologies?

There’s no way for anyone else to assess, or even for me to assess reliably, the subjective amount of effort I’m making. So how can I, when unable to perform consistently, express that the thing, principle or person is still important?

Can I ever be good enough, do enough, love enough to have it mean something?”

Looking that up was interesting because it really made my point: This theme recurs. It recurs because the question is always relevant in a world that needs us to do our best. It’s not going to stop recurring, and I need to meet it with honesty and humility whenever it arrives.

I want to believe that if I get very ill I’ll use the time and the change in perspective to write, or at least expand my mind by learning a new language or something. I want to believe that if I die of natural causes at an advanced age, my feeble fingers or quavering voice will still be trying to communicate. I want to believe that my mind is and always will be more powerful than my body.

I want to believe my drive toward thought and clarity can always overcome issues with my body. And there is some truth and merit to the idea; there’s truth in the idea that my mind and soul have a great deal of power. There’s truth in the idea that the battle for clarity is not hopeless and that it’s well worth fighting.

That belief, however, is not always backed up by actual experience. My experience has been that my mind’s activities are linked to the functioning of a physical object known as my brain. This organ, whether I like it or not, is a part of my physical body. It’s affected by every other organ I have. It relies on the contents of my bloodstream for oxygen and nutrients. When my body gets sick, or is affected by hormone fluctuations, or takes a new medicine, my brain gets a different cocktail. There’s a tipping point to these things beyond which it’s very hard to muster enough energy or original thought for any productive act.

The truth is that for someone like me, the state of optimal body and brain function is more like a theoretical norm than an actual one in the sense that there always seems to be something going on. As I age and experience more physical issues and age-related cognitive decline, the clouds may get thicker. This thought scares me quite a bit.

As I often do when I feel fear, I grope for a metaphor. Today it’s astronomy.

Astronomers, as least the old-school or amateur types who must perform their observations from the surface of the Earth, try do their field observations on clear nights. When it is cloudy, they reschedule, because the portable instruments they have may not be powerful enough to get anything useful through the cloud cover.

But what if the climate changed and it was always, or nearly always, overcast? They’d have two choices: give up astronomy or build more powerful instruments (or do all their observations from space, but in this metaphor that seems like a post-death thing and we are looking at this lifetime.)

Even if they began to build better instruments, they’d have to accept that they now get less data for more work. They’d have to decide it was still worth the work and dedication.

I have to accept a similar thing. I have to believe that an effort I make on one of my bad days is still vastly, stupendously superior to doing nothing.

Don’t get me wrong–I’m proud of being able to wash dishes. For years, it was a task shuffled off to my spouse; even more so than other mundane tasks because the specific posture and movements dishes require triggered my lower back pain intensely. Today, he can come home and have anywhere from a 75% to 95% chance of finding the sink and counter clear. Maybe not clean, but at least clear of objects.

The presence of clean dishes can, like laundry or a walked dog, be diagnostic. It can mean that I’m doing well enough physically and mentally to take positive actions. It makes sense that someone who loves me is pleased to see it.

But sometimes dishes tell gleaming, ceramic lies.

Sometimes clean dishes don’t mean anything at all, and the effort that produced them has nothing to do with how I am doing. Sometimes they’re the one task I do that day, not as a small accomplishment but as a ritual of guilt. Sometimes doing the dishes was just a postcard to a distant land where what I do means anything.

So, if your loved one is living with significant depression, don’t believe their foamy sales pitch. Don’t let the dishes convince you that things aren’t that bad. Understand that those duplicitous cups and plates don’t mean that your loved one washed their hair lately, or took their medicine, or had a day free of harming themselves.

And it’s not just dishes that can be lying bastards. Anything can. I used to meet weekly with a woman living in the most crushing, despairing gray mental landscape imaginable. The only time she left her cluttered and neglected home was for appointments related to her physical and mental health issues, but when she arrived to see me she was nicely dressed, clean and made up. Once a week, she’d dragged herself through a misleading shower, put on false-tongued cosmetics and walked into the world for a short outing before reverting to what was real for her.

People can love us, but they can’t save us. So I’m not saying that it’s anyone’s job to read our minds–I just want us, those who suffer both directly and indirectly from these scourges of the mind–to know that there’s often more going on than meets the eye.

You don’t have to have a diagnosis for this to be true, of course. Your boss who seems so full of himself cried like a baby in his therapist’s office earlier today. The guy who sold you a car spent last night compulsively masturbating to Internet porn, missing his wife who left him over his addiction. The prom queen’s bulimic, the football captain was molested; pretty much everyone has a disconnect between how they seem and how they are really doing.

I try to be pretty honest about how I’m doing–at least to the degree that I am able to be honest with myself. Even so, it’s just not possible to brief my loved ones in depth constantly; they’d be unable to function in their own lives if I did. When a family member asks how I am, the answer they get is never the whole story, and when I say goodnight in the evening there are always unread chapters.

Yes, I and others do sometimes make cries for help. But we do the opposite too. We try to look better, just a little, because we hate being a burden. Because we’re sick of trying to describe how we feel, and we imagine that the people we love are just as sick of hearing about it. We try to tough it out, and we try to do something, anything, to inject a little normalcy into the lives of those around us.

We do the dishes. And that’s a good thing, to do something. It’s better than staring at the wall.

After a very long downward spiral of diabetes/low thyroid/weight gain/depression feedback loop fun, things have begun to move in the other direction since spring. It began with a desperate, no-holds-barred attempt to bring my blood sugars under control with a change in eating–a change that, surprisingly, worked well. It accelerated when this change, somehow immune to my eating/weight baggage because it was serving the blood glucose meter and not the scale, began to have the side effect of taking off a little weight. It accelerated more when something about what I was doing affected my thyroid and my levels approached normal for the first time in years. My most recent labs are a thing of beauty compared to the values of last year.

So why is this a dangerous thing?

It feels dangerous because a part of my psyche is convinced good things won’t stay. A lot’s been written about the psychology of growing up in a household of substance abuse and/or violence, but you have to be one of us to know the sickening plunge of fear that comes when the unpredictable trouble erupts. Everything seems all right, then the floor drops out from under you and you’re in fight/flight/freeze mode. And because you’re a kid, sometimes the third one is the only available option.

Anyway, that part tends to make itself heard when things are going well. I have an inner conviction that something awful is about to happen, and when something bad does happen it’s taken as a confirmation that I was right.

The more I feel a sense of hope about the improvements in my health, the more convinced I am that some terrible punishment awaits. The resistance I battle every time I write something or do anything else positive is almost palpable. It fuels itself with everything from little symptoms to relatives’ ailments to the news: “You, or someone you love, or the planet, is going to pay a price for your selfish behavior. It’s only a matter of time.”

I anthropomorphize the general phenomenon of addiction; many of us do. Especially as we struggle with abstaining, it can be helpful. You want to resent something? Resent that. You need somewhere to direct your rage, your hatred, your frustration? Hate the thing that wants you dead; that wants us dead. Hate the thing that wants to eat your soul and replace it with its eternal craving.

It’s not that we deny our responsibility for our situation or our duty to keep fighting. But in the midst of the humility we need to seek and find, sometimes we need to rebel. So yes, I welcome the rage and the rebellion sometimes.

I recently spent time in the hospital with an addict who has been on dialysis for years and has now just had open heart surgery. Still on methadone, she has the accompanying high tolerance for pain meds. I listened to her repeated begging for more medication as the pain resisted treatment. I watched her be in the power of nurses–some kind, some not–who questioned the validity of every request.

I watched her frail body curling in on itself, like a leaf curling and withering in a flame. I could almost see addiction as the fire in which she burned.